Ultrastructure of a Sertoli-cell adenoma of the testis

Sertoli cell tumors of the testis, not otherwise specified: a clinicopathologic analysis of 60 cases

Sixty Sertoli cell tumors of the testis, excluding large cell calcifying and sclerosing subtypes, are described. Patient age ranged from 15 to 80 years (mean, 45 years). The initial manifestation was usually a testicular mass; in 14 cases it had been enlarging slowly for a period of up to 14 years (mean 3.7 years). Only five patients had testicular pain. Four patients had metastatic disease at the time of presentation. All the tumors were unilateral and ranged from 0.3 cm to 15 cm (mean 3.6 cm). They were typically well circumscribed. Sectioning usually disclosed firm, tan-gray, white, or yellow tissue with areas of hemorrhage and a minor cystic component in approximately one third. Microscopic evaluation usually revealed diffuse sheets or large, nodular aggregates of tumor cells, within which solid or hollow, sometimes dilated, tubules and, less often, cords were usually at least focally identifiable. A relatively acellular, often vascular, fibrous to hyalinized stroma was frequently conspicuous. The tumor cells typically had moderate amounts of pale to lightly eosinophilic cytoplasm, but 10 tumors had cells with abundant eosinophilic cytoplasm. Large cytoplasmic vacuoles were prominent in 26 tumors. Nuclear atypicality was absent or mild in 54 cases, moderate in 4 cases, and marked in 2 cases. Mitotic rate ranged from less than 1 to 21 per 10 high power fields, with 50 tumors having no or only rare mitoses. Vascular space invasion was present in 11 cases and was prominent in 8. Follow-up of more than five years (average 8.4 years), or until evidence of metastasis was seen, was available for 16 patients. Nine were alive and well with no evidence of disease. Four were alive with disease and three died of disease. The pathologic features that best correlated with a clinically malignant course were as follows: a tumor diameter of 5.0 cm or greater, necrosis, moderate to severe nuclear atypia, vascular invasion and a mitotic rate of more than 5 mitoses per 10 high power fields. Only one of nine benign tumors for which follow-up data of 5 years or more were available had more than one of these features, whereas five of seven malignant tumors had at least three.

Juvenile granulosa cell tumor of the infant testis: case report with ultrastructural observations

This report describes the light-microscopic and ultrastructural features of a juvenile granulosa cell tumor of infant testis. Microscopic examination revealed a macrofollicular patterns simulating the preovulatory Graafian follicle and the juvenile granulosa cell tumor of the ovary. Ultrastructure confirmed three cell types: granulosa, theca interna, and externa, with occasional luteinized cells lacking crystalloids of Reinke. Charcot-Bottcher crystalloids were not detected, though rare cells contained a complex arrangement of filaments. An ultrastructural comparison was carried out with infant testes (2 cases), preovulatory Graafian follicle (1 case), juvenile granulosa cell tumor of ovary, adult granulosa cell tumor of ovary, and adult Sertoli cell tumor of testis and ovary. Ultrastructural similarities were noted between the present case and primitive Sertoli cells, preovulatory granulosa cells, and juvenile granulosa cell tumor of ovary. This may reflect the common histogenesis of Sertoli/granulosa cells from the common specialized gonadal stroma.

Large cell calcifying Sertoli tumor of the testis. Light microscopic and ultrastructural study

Large cell calcifying Sertoli tumor of the testis was found in a 16-year-old boy who had presented with gynecomastia. Serum estrogen level, which had been elevated preoperatively, returned to normal following orchiectomy. Charcot-Bottcher crystalloids are demonstrated in the neoplastic Sertoli cells.

Malignant sex cord-stromal tumor of testis

We report a case of sex cord-stromal tumor in the testis, which metastasized to the retroperitoneal space, resulting in death 13 months after orchiectomy. The primary lesion consisted of granulosa cells, theca cells, Sertoli cells and undifferentiated gonadal stroma. Biopsy of the retroperitoneal metastasis showed predominance of the Sertoli cell component.

Testicular stromal tumor with myofilaments: ultrastructural comparison with normal gonadal stroma

The ultrastructural features of two testicular stromal tumors were compared with those of normal gonadal stroma. The two patients with tumor were 28 and 48 years old and had no endocrine abnormalities. No metastases or recurrences occurred after 32 and 12 months of follow-up, respectively. The tumors were composed of bundles of oval to spindle-shaped cells. Ultrastructurally, intracytoplasmic myofilaments were characteristic of the tumor cells, which resembled the contractile peritubular and interfollicular cells of normal testis and ovary. In normal testicular tissue, an intertubular mesenchymal cell may differentiate into a peritubular contractile cell or into an interstitial (Leydig) cell. Therefore, testicular stromal tumors with myofilaments may originate from an intertubular mesenchymal cell that is capable of differentiating into a cell with contractile elements.

Large-cell calcifying sertoli cell tumor of the testis. An ultrastructural, immunocytochemical, and biochemical study

This report describes the ultrastructural and hormonal characteristics of the recently described large-cell calcifying Sertoli cell tumor of the testis, a rare subtype of pure Sertoli cell tumor. The ultrastructural findings showed similarity to normal Sertoli cells, pure Sertoli cell tumors, Sertoli cells in azoospermic human testes, and the Sertoli cell component of Sertoli-Leydig cell tumors. Ultrastructure indicated features common to steroid-producing cells. Testosterone and estradiol were demonstrated in the tumor by immunocytochemical and biochemical methods.

Sertoli cell and sertoli-Leydig cell tumors of the ovary. A report of three cases with ultrastructural findings

Three tumors of the ovary containing Sertoli cells were studied by light and electron microscopy. Two of these tumors were well-differentiated neoplasms with epithelial cells often forming tubules. These cells were cylindrically shaped, contained round to oval nuclei and stood on a thin basement membrane. The cytoplasm was fibrillary and showed rough and smooth endoplasmic reticulum, lipid droplets and secretory granules. At the luminal borders the cells were often irregular and displayed apocrine-like activity. Having compared our data with results of studies from the literature of normal Sertoli cells, Sertoli cell adenomas of the testis and cells from other parts of the male reproductive system and those of normal ovarian stroma, we conclude that the Sertoli cell is most probably the cell of origin of these tumors. The third tumor was undifferentiated with a sarcomatoid appearance and contained islands of cartilage, which we consider to be metaplastic.

Small cell carcinoma of the ovary with hypercalcemia: a report of eleven cases

Eleven cases of a small cell ovarian cancer associated with hypercalcemia that was reversed by removal of the tumor are reported and compared with three similar cases in the literature. The 14 cases account for 50% of recorded cases of ovarian-cancer-related hypercalcemia. The 14 tumors occurred in women between the age of 13 and 35, with an average of 22 years and, with two exceptions, behaved clinically in an aggressive fashion. Light and electron microscopic study confirmed the epithelial nature of the neoplasms but failed to disclose their specific subtype or origin.

Sertoli tumors of the ovary. A clinicopathologic study of 28 cases with ultrastructural observations

The clinical and pathologic features of 28 Sertoli tumors of the ovary are presented. Seventeen of the 18 neoplasms had a functional effect. The effects were hyperestrinism (eight women), isosexual precocious puberty (three girls), virilization (four women), a progestational decidual reaction on the peritoneum (one woman), and a combination of virilizing and estrinizing signs (one woman). There were three histologic patterns: simple tubular, complex tubular, and folliculome lipidique. Two neoplasms recurred, both of which had the distinctive feature of invasion of the supporting stroma by individual and columns of tumor cells in the original tumors. Electron microscopic evaluation of three neoplasms disclosed. Charcot-Böttcher filaments unequivocally identifying the Sertoli differentiation of the predominant cells in the neoplasm. The identification by electron microscopy of a smaller population of cells within the three tumors similar to typical ovarian stromal cells suggests that Sertoli tumors arise from ovarian stromal cells.

Ovarian Sertoli-Leydig cell tumors. A clinical, pathological and ultrastructural study with particular reference to the histogenesis of these tumors

Ovarian Sertoli-Leydig cell tumors are rare, most of them being endocrinologically active and causing virilization. Their histogenesis and nomenclature are still under discussion. Six such tumors were identified in the Laboratory for Histopathology of the University Women's Hospital, Zürich. The clinical data as well as the macroscopic, microscopic and ultrastructural features of these tumors are analysed and discussed. In an attempt to clarify their histogenesis, the ultrastructural features of these tumors have been compared with those of two granulosa cell tumors as well as with those of a testis in a patient with testicular feminization. Our own results and a study of published data suggest that Sertoli-Leydig cell tumors arise from ovarian stroma. Because of their obvious morphological similarities to testicular structures they should be termed "gonadal stromal tumors of android type".

Pure Sertoli cell tumour of the ovary: report of a case with ultrastructural observations

A case of pure Sertoli cell tumour of the ovary is described. Unusual features were its great size, lack of clinical hormonal activity and the presence of granulomas in its interstitium. Mitochondria with tubular christae are described for the first time in such a tumour. These, together with lipid droplets and plentiful smooth endoplasmic reticulum, suggest a potential for steroid hormone synthesis which was not expressed clinically. Dense membrane-bound granules of undetermined type were present in large numbers. The presence of cilia and microvilli, and the absence of annulate lamellae and Charcot-Böttcher crystalloids, suggests that the tumour cells may not be truly of Sertoli type.

Sertoli cell tumors of ovary: light microscopic and ultrastructural study with histogenetic considerations

Two cases of pure Sertoli cell tumors of the ovary are presented. The tumors were grey to brown and generally solid, but with several cystic areas. They showed a highly differentiated, but variable, histologic patterns with solid cords of neoplastic cells, as well as tubular formations. Ultrastructurally, the basal part of the cells rested on a nonfibrillary basement membrane layer while the free border showed occasional cilia. Laterally, the cells showed tight junctions and desmosomes. Abundant rough endoplasmic reticulum and some cystically dilated smooth endoplasmic reticulum were evident. The theories regarding the histogenesis are discussed. Enough similarities, both by light and by electron microscopy, are presented between these tumors and the Sertoli cell to justify classifying these ovarian tumors as Sertoli cell in type. The development of cilia is considered to be a manifestation of focal metaplasia of the neoplastic Sertoli cell.